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Purpose <p>This study investigated the relationship between log odds of positive lymph nodes (LODDS) and the long-term prognosis in pathological stage 3 obstructive colorectal cancer (CRC) patients who underwent self-expandable metal stent (SEMS) insertion as a bridge to surgery (BTS).</p> Methods <p>This retrospective multicenter study included 75 patients with stage 3 CRC. The patients were classified into high-LODDS (LODDS-H, n = 32) and low-LODDS (LODDS-L, n = 43) groups.</p> Results <p>Significant differences were found in the 5-year relapse-free survival (RFS) rates (LODDS-H: 34.0% vs. LODDS-L: 53.1%; p = 0.041) and overall survival (OS) rates (52.4% vs. 68.3%; p = 0.012). A multivariate analysis revealed that blood loss [hazard ratio (HR) 2.266, 95% confidence interval (CI), 1.142–4.494; p = 0.019] was an independent predictor of the RFS. Age ≥ 75&#xa0;years old (HR 2.769, 95% CI 1.206–6.360; p = 0.016), blood loss (HR 3.552, 95% CI 1.460–8.643; p = 0.005), adjuvant chemotherapy (HR 0.415, 95% CI 0.177–0.972; p = 0.043), and LODDS (HR 3.593, 95% CI 1.511–8.544; p = 0.004) were independent predictors of OS.</p> Conclusions <p>The LODDS appears to be prognostically accurate for patients with stage 3 obstructive CRC undergoing BTS. Incorporating the LODDS into clinical evaluations may enable more accurate prognostic stratification.</p>

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Impact of the log odds of positive lymph nodes on the prognosis in pathological stage 3 patients with obstructive colorectal cancer treated with colonic stents: a retrospective multicenter study in Japan

  • 期刊论文

  • 发表日期：

    2025年5月15日

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  • Toshio Shiraishi,
  • Tetsuro Tominaga,
  • Takashi Nonaka,
  • Yuma Takamura,
  • Kaido Oishi,
  • Shintaro Hashimoto,
  • Keisuke Noda,
  • Rika Ono,
  • Makoto Hisanaga,
  • Akiko Fukuda,
  • Masaaki Moriyama,
  • Fumitake Uchida,
  • Kazuki Motoyama,
  • Masaki Kunizaki,
  • Keitaro Matsumoto

摘要

Purpose

This study investigated the relationship between log odds of positive lymph nodes (LODDS) and the long-term prognosis in pathological stage 3 obstructive colorectal cancer (CRC) patients who underwent self-expandable metal stent (SEMS) insertion as a bridge to surgery (BTS).

Methods

This retrospective multicenter study included 75 patients with stage 3 CRC. The patients were classified into high-LODDS (LODDS-H, n = 32) and low-LODDS (LODDS-L, n = 43) groups.

Results

Significant differences were found in the 5-year relapse-free survival (RFS) rates (LODDS-H: 34.0% vs. LODDS-L: 53.1%; p = 0.041) and overall survival (OS) rates (52.4% vs. 68.3%; p = 0.012). A multivariate analysis revealed that blood loss [hazard ratio (HR) 2.266, 95% confidence interval (CI), 1.142–4.494; p = 0.019] was an independent predictor of the RFS. Age ≥ 75 years old (HR 2.769, 95% CI 1.206–6.360; p = 0.016), blood loss (HR 3.552, 95% CI 1.460–8.643; p = 0.005), adjuvant chemotherapy (HR 0.415, 95% CI 0.177–0.972; p = 0.043), and LODDS (HR 3.593, 95% CI 1.511–8.544; p = 0.004) were independent predictors of OS.

Conclusions

The LODDS appears to be prognostically accurate for patients with stage 3 obstructive CRC undergoing BTS. Incorporating the LODDS into clinical evaluations may enable more accurate prognostic stratification.